430700549-6-21-2024-07-CC-AMOS-D6FPXG-20240621114220

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430700549
Report Date: 06/19/2024
Date Signed: 06/21/2024 11:42:27 AM

Document Has Been Signed on 06/21/2024 11:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME:	SAN JOSE DAY NURSERY		FACILITY NUMBER:	430700549
ADMINISTRATOR/ DIRECTOR:	ELENA JOLLY		FACILITY TYPE:	850
ADDRESS:	33 NORTH 8TH STREET		TELEPHONE:	(408) 288-9667
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95112
CAPACITY: 88	TOTAL ENROLLED CHILDREN: 88	CENSUS: 50	DATE:	06/19/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Angela Gomez		TIME VISIT/ INSPECTION COMPLETED:	04:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analysts (LPA's) Anna Morales and Andrea Cortez conducted an Annual Random and was greeted by Executive Director Angela Gomez. Days and hours of operation is Monday- Friday,7:00am 6:00pm, serving ages from two years-entry to First Grade. Facility's License, Notification of Parents’ Rights Poster, Child Car Seat Law, Personal Rights (LIC 613A), Emergency Disaster Plan, and Earthquake Preparedness Checklist were observed to be posted. Disaster Drill was conducted in 4/1/2024. The Preschool Program is operating in Room One,Two,Three(3)Empty,Four, Five, and Six. LPA's observed that the facility was operating in compliance with teacher to children ratio requirement. Children were engaged with activities with supervision of staff. If a child comes to the facility who exhibit symptoms of illness including, but not limited to, fever or vomiting, they are not accepted into care. Any child who become ill during the day, shall be isolated in a vacant classroom until parent pick-up. LPA's toured the facility both indoor and outdoors. There were no bodies of water observed. Director stated that they do not have weapons on the premises. Furniture and equipment were observed to be age appropriate and in good condition, free of sharp, loose, or pointed parts. Disinfectants, cleaning solutions, and other items that are dangerous to children were stored inaccessible to children. Floors were clean. LPA's observed cubbies for the children's personal belongings.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAN JOSE DAY NURSERY	FACILITY NUMBER: 430700549
	VISIT DATE: 06/19/2024

NARRATIVE

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LPA's observed charged Fire extinguishers. Director stated that the Smoke Detectors and Carbon monoxide detectors are interconnected(hard wired).

Activity spaces are enclosed by fencing and are observed to be free of hazards. LPA's observed play equipment were in good condition. LPA's observed shade. Drinking water was readily available to children indoor and outdoor. Activities schedule and Snack Menu were posted. Facility provides, breakfast, lunch and snacks in the morning and in the afternoon. LPA's observed that food storage areas were clean and free of litter. LPA's provided the Program Director with website resources on managing food allergies at school and handling medical emergencies related to food allergies.
CDC Managing Food Allergies at School
https://www.cdc.gov/healthyschools/foodallergies/index.htm
American Academy of Pediatrics Healthy Children Medical Emergencies
https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/When-to-Call-Emergency-Medical-Services-EMS.aspx

This facility provides Incidental Medical Services. LPA reviewed storage of "medication and equipment/supplies,and reviewed children's, personnel and administrative records. . For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 and link to publication. Commonly Asked Questions about Child Care Centers and the ALPDA are available at: https://www.ada.gov/resources/child-carecenters/.

The facility maintains an electronic sign in and out system, that is updated throughout the day, containing full signatures from responsible parties. The facility maintains an updated roster of children enrolled in the program electronically through the same program.

A sampling of children and staff files was taken for review during today's inspection. Children records reviewed include Admission Agreement, Identification and Emergency Contact, Consent for Emergency Medical Treatment , receipt of Parent Rights Notice, Personal Rights Notice, Medical Assessments, and Immunizations.

Staff records reviewed include Criminal Record and Child Abuse Index Clearance, Health Screening Report and TB test, Immunization (Measles, Pertussis, and Flu) record and required Training. LPA reminded Director that the online AB1207 Mandated Reported Training needs to be renewed every two years. There was one staff present who did not have a current Mandated Reporter Training. There was at least one person with current certification in Pediatric CPR and First Aid present at the facility.

-continue LIC809C-

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE CC RO, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAN JOSE DAY NURSERY	FACILITY NUMBER: 430700549
	VISIT DATE: 06/19/2024

NARRATIVE

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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA's also reviewed with Director the violations that would result in an immediate assessment of civil penalty in the amount of $500. Director is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test). LPA's verified that the lead testing was completed in accordance to the Written Directives.

Director was informed of the MyChildCarePlan.org website; a
consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

One Type B Deficiency was cited cited at today's inspection. Exit interview was conducted and reviewed with Director. Notice of site visit was given and must remain posted for 30 days.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISORS NAME: Gladys Kuizon
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE:	DATE: 06/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/21/2024 11:42 AM - It Cannot Be Edited

Created By: Anna Morales On 06/19/2024 at 03:50 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SAN JOSE DAY NURSERY	FACILITY NUMBER: 430700549
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/19/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

(b)(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review and interview, the licensee did not comply with the section cited above as Staff one(S1) is missing proof of current Mandated Reporter training, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/03/2024
	Plan of Correction
1 2 3 4	Director stated that she will submit a current copy of S1 Mandated Reporter Training to CCL by the POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Gladys Kuizon

LICENSING EVALUATOR NAME:

Anna Morales

LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024

LIC809 (FAS) - (06/04)

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